Giving. Thanks.

Today is the holiday in the US that many consider their favorite. It is a day set aside by Abraham Lincoln during one of the worst periods of American history for people to take stock of all they are thankful for. It is a day that ("black friday" creep notwithstanding) has escaped the crass commercialization of the December holidays.

In my house, it is a day for a huge group of relatives from varying distances to descend on our home and stuff it to to the gizzard with singing, laughing, story-telling, and re-connecting. For someone who came from a reserved, northern european, "you give my distance and I'll give you the same" background, it is a little bit intimidating. I simultaneously want to engulf myself in the chaos and escape from it. I am equally sad to see people leave, and relieved to once again enjoy some peace and elbow room.

I think that balance/tension extends to the idea of being thankful as well. Having gone through one of the most trying years of my life, I am thankful simply to have survived without a major crisis. The financial uncertainty of the recent past and the present does put a cloud over things like never before for me. The certainties of life have been replaced by questions. The confidence of the future now must become faith. The past year's journey has been, in many ways, one of loss, struggle, and stress. Yet if I had a chance to hit the reset button and go back to my old, more comfortable and confident life, would I? Not a chance. In that sense, I give thanks for my loss.

I have seen through the lives of my patients a pernicious belief that emotion must by unified. Either a person is happy or they are sad. Either life is good or it is bad. Either I like my full house of people or I don't. Either I am sad about my loss or I am happy. This simply is wrong. I am never in a position where I don't have regret, struggle, or pain. I am never in a position where there is not uncertainty. I am surrounded with examples of the unfairness of life and the seeming randomness of calamity. Yet my life is also never devoid of good things. I can always look back with gratitude at the people I've met, the relationships I've had. I have freedoms, I have family, I have friends, I have a job, I have my talents, I have music, love, and laughter. My uncertain future always also has hope. So I am simultaneously happy and sad. I am equally grateful for the good and disappointed, frustrated, or angry about the bad. So many people feel guilty about having negative feelings when they have so much to be grateful for, or hypocritical about feeling happy when there is so much uncertainty or pain around them.

This is life. Life is always a mix. Silver linings don't negate dark clouds, and shadows cannot exist without light. The more we can all accept this tension and balance, the less we will condemn ourselves (or others) for not feeling the way we "should."

So on this day, a day commemorating the good that exists within lives filled with hardship, I want to give thanks.

Thank you to all who have supported me and encouraged me over this past year. I operate largely by the force of my belief and passion about things, and that fire can die down over the course of a grueling year. You all stoked those fires back up and gave me the will to push on through hard times.

Thank you to the people who have stood by me when I wasn't easy to be with. My personal uncertainty, moodiness during self-doubt, and blatantly bad decisions have given cause to leave me to myself. I thank my family and friends who have put up with me during this time.

Thank you to my parents. I see now just how blessed I am to have inherited both your genes and your example of how to live life well.

Thanks to my patients who have joined me in this journey. It is humbling to realize that some people truly believe in what I am doing. Many say how they admire what I am doing and how they believe that this is the right way to give care, but very few are willing to pay the admission fee to a ride where the end is uncertain. That show of faith in me is incredibly powerful. It is something I will never forget and always treasure.